WHEN the slightest contact with nuts could kill your child, you can never truly relax. Giulia Rhodes meets one family who are learning to live with anaphylaxis

Caitlin Cawte is a lively 11-year-old girl who enjoys playing football with her friends. But, like a growing number of children, she also has a severe food allergy – in her case to almonds, peanuts, hazelnuts and walnuts – that could kill her.

Two and a half years ago, during her most severe reaction, Caitlin stopped breathing. She was only saved by an adrenaline injection from the EpiPen that severe allergy sufferers have to carry.

It was, says her mother Kerry, 36, “absolutely terrifying”. Caitlin had been playing happily but then began to complain of stomach pains. “She was behaving very strangely and became quite aggressive,” says Kerry. “Then she went grey, collapsed and stopped breathing.”

The reaction – triggered when a family friend who had eaten peanuts kissed Caitlin, happening to catch a small scratch on her face – was a sobering reminder of the need for constant vigilance.

One in 50 children in the UK suffers from a peanut allergy, while an estimated eight per cent has some form of food allergy. These can cause a range of symptoms including digestive problems, itchy skin and a runny nose. In the most severe cases, known as anaphylaxis, life-threatening reactions include swelling in the mouth and throat, difficulty breathing, heart rate and blood pressure problems and unconsciousness. Emergency treatment is vital.

Doctors are reporting a dramatic increase in emergency hospital admissions as a result of these severe allergic reactions (the most recent statistics, dating from 2004, already reveal a 700 per cent increase since 1994). So far, there is no definitive explanation – hypotheses include excessive hygiene and lack of exposure to allergens – so parental vigilance is key.

Later this year more stringent requirements will be introduced for food labelling, and research into the treatment and prevention of anaphylaxis is promising. But for Caitlin and her family, progress can’t come soon enough. “Anaphylaxis kills,” says Kerry, who lives in Portsmouth with her husband Richard and their two children. Caitlin has a younger brother, Jack, seven. “People don’t realise that, but Caitlin’s last reaction really brought it home to us. The worry is always there in the background, like a ticking bomb.”

Caitlin was diagnosed with her allergies when she was six, after reacting to a home-made peanut brownie. But she had previously eaten cereals, biscuits and other products containing nuts with no adverse reaction.

“Allergies were just not on our radar – she’d even had peanut butter,” says Kerry. “But as she was eating this brownie she said her tongue felt odd. My husband saw that it was red and swollen and fortunately he recognised the signs of an allergic reaction and gave her antihistamine.”

The family were simply told to avoid peanuts – but three months later Caitlin suffered a second, more severe, reaction, this time after eating chocolate containing almonds. “Within seconds of taking one bite her face had swollen so you couldn’t see her eyes,” recalls Kerry. “She also had an angry red rash up her arm, neck and face.” Caitlin was given antihistamine again and rushed to hospital.

This time the family were told to avoid all nuts and referred to a paediatrician. A blood test confirmed an allergy to peanuts and hazelnuts, and Caitlin was given an EpiPen.

“But we didn’t feel we were getting the support we needed or all the answers,” says Kerry. “The blood test didn’t highlight almonds, despite the severe reaction that Caitlin had just suffered. We also weren’t told just how serious this could be. It was only when I did my own research that

I realised it could be life-threatening. Sadly that is not unusual – children are not always seen by allergy specialists and many families aren’t getting the information they need.”

11-year old Caitlin Cawte learned to live with anaphylaxis, a severe food allergy [SIMON JOHN]

We are just trying to give her as much knowledge and confidence as possible because, of course, we want her to have fun

Caitlin's mum

On the advice of charity the Anaphylaxis Campaign, Kerry pushed for a referral to an allergy clinic. Caitlin was eventually seen at the University of Southampton where she was given skin and blood tests. She is now re-examined annually, which is particularly important as hormonal changes can also affect allergies.

“We were finally given a definitive list of Caitlin’s allergens,” says Kerry. “And we now know that almonds would be fatal.”

Although this information was invaluable, it was also frightening. “You have to feed your child so the anxiety is constant,” says Kerry. “But we knew we couldn’t just wrap her up in cotton wool and keep her at home We had to let her have a life.”

Checking everything – toiletries as well as foods – soon became second nature to Kerry, but she and Richard knew that Caitlin also needed to learn about her condition.

“We avoid bakeries, buffets, anything where the food isn’t wrapped,” says Kerry. “But we did decide to take her to restaurants and make her ask about the food. We also wanted her to feel happy going to parties.”

As Caitlin grows older, it’s increasingly important that she can manage her own condition. She is able to play out with her friends but always carries her EpiPen and a phone, which her friends also know to use if necessary.

“She is coming up to senior school age and I worry about the teenage years,” says Kerry.

“When things do go wrong it is often with older children or students who have made a bad choice or forgotten their EpiPen. We are just trying to give her as much knowledge and confidence as possible because, of course, we want her to have fun.”

Ensuring that Caitlin can make informed choices and minimise risks, without becoming overly frightened and anxious, can be a difficult balance to strike.

“At first she was quite angry about it – she didn’t want to be different,” says Kerry. “She was also very scared because she remembered the reaction as so horrible. She thought she was going to die and for a long time after that she would shake with fear if she even saw anything with nuts in it.”

Caitlin’s state of mind was hugely improved by befriending children of her age who also have a nut allergy. She has now thrown herself into fundraising for the Anaphylaxis Campaign, raising more than £900 on a sponsored bike ride.

“We try to focus on what she can have rather than what shecan’t,” says Kerry. “Now she doesn’t panic, she just moves away from a problem food. She has been forced to grow up more than she might have done but we are all happier because she is happier.”

Non-food allergens include insect stings, latex, penicillin or other drugs, and exercise (often in conjunction with another allergen).

Doctors do not know why certain people develop severe allergies but it is more likely in children with a family history of allergies – asthma, eczema and severe infant eczema.

Allergies can develop at any age but are most common in young children. The child becomes sensitised to the allergen on one exposure, then reacts to future exposure. Even the mildest of reactions should be investigated.